Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Department of Acute and Critical Care Medicine, National Trauma Regional Medical Centre of Nanfang Hospital, Southern Medical University, Guangzhou, China.
BMC Cardiovasc Disord. 2024 Nov 1;24(1):608. doi: 10.1186/s12872-024-04277-0.
In order to investigate the association between the use of cardiomyopeptidin (CMP) and outcomes in critically ill patients with myocardial injury, we conducted a retrospective cohort study in Nanfang hospital, Southern Medical University. Clinical data of patients with myocardial injury were collected retrospectively and adjusted for possible confounders by propensity score weighting. The main outcome was the in-hospital mortality. Secondary outcomes included the major adverse cardiovascular events (MACE) occurring during the hospital, the individual components of MACEs, changes in high sensitive troponin T (hsTnT) levels, length of stay (LOS) in ICU and hospital. A Cox proportional hazards model was constructed to examine the association between the application of CMP and in-hospital mortality. Logistic regression and linear regression are used to analyze secondary outcomes. In total, 339 critically ill patients with myocardial injury were included in the analysis. After inverse probability of treatment weighting (IPTW), the use of CMP was associated with reduced in-hospital mortality (HR: 0.64, 95%CI: 0.43-0.96, P = 0.03). No significant differences were found in change of hsTnT, the occurrence of MACE and LOS in ICU as well as hospital after IPTW. The association was more significant in the subgroup with hsTnT > 3URL (HR: 0.41, 95%CI: 0.23-0.71, P < 0.001) and APACHE II score < 25 (HR: 0.13, 95%CI: 0.17-0.59, P < 0.001). Cardiomyopeptidin was associated with reduced in-hospital mortality in critically ill patients with myocardial injury. Our study provides initial clinical basis for the application of CMP with cardio-protective effect in critically ill patients. These results need to be confirmed in future randomized controlled trails.
为了研究心肌损伤危重症患者使用心肌肽素（CMP）与结局的关系，我们在南方医科大学南方医院进行了一项回顾性队列研究。回顾性收集心肌损伤患者的临床资料，并通过倾向评分加权调整可能的混杂因素。主要结局为院内死亡率。次要结局包括住院期间发生的主要不良心血管事件（MACE）、MACE 的各个组成部分、高敏肌钙蛋白 T（hsTnT）水平的变化、重症监护病房（ICU）和医院的住院时间（LOS）。构建 Cox 比例风险模型来检验 CMP 应用与院内死亡率之间的关系。使用逻辑回归和线性回归分析次要结局。共纳入 339 例心肌损伤的危重症患者进行分析。在进行逆概率处理加权（IPTW）后，CMP 的使用与降低院内死亡率相关（HR：0.64，95%CI：0.43-0.96，P=0.03）。在 IPTW 后，hsTnT 变化、MACE 发生以及 ICU 和医院 LOS 均无显著差异。在 hsTnT>3URL（HR：0.41，95%CI：0.23-0.71，P<0.001）和急性生理与慢性健康评分（APACHE）II 评分<25（HR：0.13，95%CI：0.17-0.59，P<0.001）的亚组中，相关性更为显著。心肌肽素与心肌损伤危重症患者的院内死亡率降低相关。本研究为 CMP 在危重症患者中具有心脏保护作用的应用提供了初步的临床依据。这些结果需要在未来的随机对照试验中得到证实。
